Metabolic bone disease (MBD) is a significant concern in very preterm neonates, with clinical signs often delayed compared to biochemical and radiological markers. MBD was defined as serum phosphate <1.81 μmol/L and alkaline phosphatase >600 IU/L or alkaline phosphatase >1000 IU/L. Key risk factors included lower gestational age, lower birth weight, prolonged total parenteral nutrition, delayed attainment of full enteral feeding (>7 days), cholestasis, bronchopulmonary dysplasia, and anaemia requiring transfusion. Logistic regression identified delayed attainment of full enteral feeding (>7 days) as a significant predictor for developing MBD.
RusticoSECalabriaACGarberSJ. Metabolic bone disease of prematurity. J Clin Transl Endocrinol2014; 1: 85–91.
2.
KovacsCS. Bone development in the fetus and neonate: role of the calciotropic hormones. Curr Osteoporos Rep2011; 9: 225–233.
3.
ChenWYangCChenH, et al.Risk factors analysis and prevention of metabolic bone disease of prematurity. Medicine (Baltimore)2018; 97: e12861.
4.
GaioPVerlatoGDaverioM, et al.Incidence of metabolic bone disease in preterm infants less than 1250g: a prospective cohort study. Clin Nutr ESPEN2017; 22: 53–58.
5.
VachharajaniAMathurAM. Metabolic bone disease of prematurity: a review of the pathophysiology and approach to management. J Neonatal Perinatal Med2018; 11: 355–363.
6.
ChinoyAMughalMZPadidelaR. Metabolic bone disease of prematurity: causes, recognition, prevention, treatment and long-term consequences. Arch Dis Child Fetal Neonatal Ed2019; 104: F560–F566.
7.
BackströmMCKouriTKuuselaAL, et al.Bone isoenzyme of serum alkaline phosphatase and serum inorganic phosphate in metabolic bone disease of prematurity. Acta Paediatr2000; 89: 867–873.
8.
MitchellSMRogersSPHicksPD, et al.High frequencies of elevated alkaline phosphatase activity and rickets exist in extremely low birth weight infants despite current nutritional support. BMC Pediatr2009; 9: 47.
9.
MishraAKDubeyVGhoshT. Metabolic bone disease in preterm infants: a study from eastern India. Int J Pediatr Res2016; 3: 234–239.
10.
FaienzaMFD’AmatoGNataleMP, et al.Metabolic bone disease of prematurity: diagnosis and management. Front Pediatr2020; 8: 143.
11.
ChenWZhangBYangC. Clinical and biochemical characteristics of metabolic bone disease in preterm infants. Medicine (Baltimore)2018; 97: e12861.
12.
GaioPVerlatoGDaverioM, et al.Metabolic bone disease in preterm infants: relationship between bone ultrasound and biochemical markers. Clin Nutr ESPEN2017; 22: 53–58.
13.
EliakimALitmanovitzINemetD. Low bone mineral density in preterm infants: the role of inflammation and early nutrition. Acta Paediatr2017; 106: 1959–1965.
14.
ChinoyAMughalMZPadidelaR. Metabolic bone disease of prematurity: a review. Arch Dis Child Fetal Neonatal Ed2019; 104: F560–F566.
15.
MitchellSMRogersSPHicksPD, et al.Elevated alkaline phosphatase activity in extremely low birth weight infants. BMC Pediatr2009; 9: 47.
16.
RehmanMUNarchiH. Metabolic bone disease in the preterm infant: current state and future directions. World J Methodol2015; 5: 115–121.
